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A-Line Staffing Solutions is seeking a Clinical Review Nurse for a concurrent review role in a remote-capable setting. The RN will assess member eligibility through chart review and coordinate with providers to gather necessary information.

Our client, a mutual benefit corporation and health plan provider, seeks an accomplished Registered Nurse (Utilization Management). *** Candidate must be authorized to work in USA without requiring sponsorship...

Piper Companies is seeking a Clinical Appeals Nurse to join a leading health insurance organization for a contract remote opportunity located in North Carolina. The Clinical Appeals Nurse will serve as a clinical...

Centene Corporation in the United States is seeking a Nursing professional to analyze prior authorization requests and determine medical necessity and level of care in line with standards and coverage. You will collaborate with medical teams to...

Ethos Risk Services is seeking a full-time Clinical Recruiter (REMOTE) to lead hiring for the Case Management division. You will own full-cycle recruiting for nurse case managers and other clinical pros, from posting to onboarding, ensuring a...

Army Public Health Nurse Job Overview As an Army Public Health Nurse, you'll assess health risks and implement programs to monitor the spread of disease. You'll promote wellness for Soldiers and their families while also informing policy and...

Job DescriptionMake a Difference Every Single Day at Cedars-Sinai!When the work you do every single day has a crucial impact on the lives of others, every effort, every detail, and every second matters. This shared culture of passion and...

1st TIME OK/ 2 YR EXP required for Utilization Review RN every other weekend required or more depending on unit needs no call or floating required MUST HAVE experience with Milliman Care Guidelines and Acute Hospital Experience!! The Emergency...

Clinical Documentation Quality Improvement (CDQI) Specialist, you will play a pivotal role in elevating the impact of our medical record documentation. You will conduct daily evaluations and engage in direct communication with providers to enhance...

School Nurse Under direction, to provide basic health services to students; to assist in the planning and implementation of school health programs in cooperation with medical authority and school administrative personnel; to evaluate the...

START Research's START Center for Cancer Research in Los Angeles is seeking a Clinical Research Coordinator, RN to support early-phase oncology trials. The role involves direct patient interaction, data collection, and ensuring protocol compliance...

Managed Medical Review Organization seeks a licensed RN for a home-office, remote role focused on telephonic customer service and clinical documentation. The position emphasizes quality review, case management, and adherence to policy, with...

Job Category: Clinical Services Nursing Requisition Number: CERTI003229 Posted : September 15, 2026 Part-Time On-site Locations Showing 1 location ...

ABOUT SOLACE Healthcare in the U. S. is fundamentally broken. The system is so complex that 88% of U. S. adults do not have the health literacy necessary to navigate it without help. Solace cuts through the red tape of healthcare by pairing...

UChicago Medicine in Chicago, IL is seeking a Clinical Documentation Nurse - Quality to join the Office of External Assessments. This role primarily offers remote work from home, with residency in Chicagoland required, and focuses on accurate...

Description: Job Summary: Provides consultation and leadership in designated areas of expertise independently. Collaborates with interdisciplinary teams and stakeholders to address issues and achieve project objectives.

TEEMA Group is seeking a Clinical Quality Reviewer (RN or LCSW) for remote work in approved states. This role focuses on reviewing clinical cases, identifying quality or safety concerns, and supporting quality improvement initiatives across a...

Tennova Healthcare- Turkey Creek Medical Center is seeking a PRN Remote Clinical Utilization Review Specialist to evaluate the necessity and efficiency of hospital services and to support payer requirements. You will review admissions and...

Harborview Medical Center invites applications for a Tele Forensic Nurse Examiner (TFE) within the FNE/SANE program. The role is fully remote, with nurses working from home and periodic remote team meetings. The position requires WA RN...

Machinify is seeking a Medical Review Nurse to perform CMS/RAC audits for government payers. This remote role involves working with a multi-location team to review claims, document findings, and support appeals. RAC certification is preferred and...

Providence Tarzana Medical Center in Tarzana, CA is seeking a Certified Nursing Assistant for the Cardiovascular Unit. This Full-Time role requires CA Nursing Assistant Certification, BLS, and completion of the Nursing Assistant course, with...

Clinical Integrity Documentation Specialist Location: Remote Facility: Ascension Wisconsin Hospitals Department: Clinical Integrity Documentation Schedule: Days | Full-Time Salary Range: $79,511.52-$110,834.59...

Effizotech is looking for a dedicated Patient Care Coordinator to join their team. This role involves coordinating patient appointments for infusion services while ensuring timely communication with patients. The opportunity offers the flexibility...

Southcoast Health seeks a Team Lead-Centralized Clinic Support to join a remote role serving MA/RI communities. The role guides nursing staff, ensures clinical workflow compliance, and drives care coordination and patient safety across ambulatory...

Job Summary: We seek a highly skilled and experienced Registered Nurse with specialties in Medical/Surgical, ICU, ER, Psychiatric, Labor & Delivery, PACU, or Operating Room to perform utilization review duties. The Registered...